Ragtime composer Scott Joplin died of complications related to dementia, as did my Nana Betto. Unlike Scott Joplin’s illness, my nana’s dementia did not come from untreated, stage four syphilis. They both died in New York City, Joplin in 1917, the same year my Nana was born. More than likely, he would not have been welcomed into Nana’s house, being African American. Those who suffered from syphilis were also outcasts, unlikely to be welcomed into anyone’s house until after 1945, when penicillin proved to be an effective cure. The efficacy of that “cure” was discovered as a result of the US government’s infamous experiment on Black men in Tuskegee, Alabama, when doctors purposefully denied them and their families treatment and relief of the disease through penicillin. The Tuskegee Study of Untreated Syphilis in the Negro Male, as it was called, was a mad experiment involving a control group of nearly four hundred Black men, and lasted from 1932 until just before I was born forty years later. To explain their needless suffering, a person would be forced to accept the tragic logic of an opera, an opus perhaps Joplin himself could have written in a fever dream or during a spate of madness brought on by the very disease he and the men from Tuskegee shared. If jazz is the great American artform, racism is the great American disease.


Syphilis was named after a character in an Italian poem by Hieronymus Fracastoro. Fracastoro would also not have been welcome at Nana’s family’s table, being Italian. From time to time, people renamed his disease, substituting the nationality of whoever they didn’t like. The Polish Disease for the Russians. The Russian disease for the Poles. Most Europeans agreed upon the French disease, since many of Napoleon’s troops passed it around, though the disease predates him. Syphilis was waiting for the Spanish when they set foot in ole Hispaniola and more than likely in America, too.

If Scott Joplin had sought treatment for his syphilis, he would have faced two grim and clumsy choices. One was the mercury cure, whereby the slippery metal was introduced to the body through baths, steam, or pills. Since mercury is quite poisonous, its use often caused tooth loss and dementia and death. The second treatment, for cases caught early, was called Syphilization, whereby the doctor would infect other areas of the body with cells from the original sore, causing more sores and shocking the body into fighting the disease more rapidly. It caused great scarring, although the treatment had some success. But all of this would have cost money, and though he wrote numerous hits over his lifetime, Joplin died as he lived those last years, quite poor. Thirty years later, researchers at Tuskegee gave the same antiquated options to the poor men at the clinic in Alabama, even after penicillin had been established as the standard treatment.


My nana was born well-off. Despite having some money, she always rattled easily. She had a case of nerves. A gross of nerves, really. Some of them frayed, others snapped. Probably more than several. What wore them down? More nerves. Who can say? Once in the late 60s, a doctor over-prescribed barbiturates and she got hooked for awhile, during one of my grandfather’s unemployment spells. She spent two years in bed, doped up, ragged and raging. Nine children, multiple miscarriages, and a husband who drank too much. The Irish Disease. At least it came in a bottle, almost like a cure.

She was an only child. Her father was an Irish-born ironworker who came to Brooklyn but hardly stayed, traveling all over the world building bridges and skyscrapers. I have a picture on my bookshelf of the iron skeleton of a building in Johannesburg and a ledger book filled with his gambling debts from the ship that he sailed on. Her mother, also Irish, was also named Agnes. She hated the name. She had two stillborn children and three miscarriages before my nana arrived. She didn’t want her only living child called Agnes though. She wanted her to be named Elizabeth. But because she’d had so many miscarriages and stillbirths, they rushed my unnamed baby grandmother from her mother’s arms to the church to be baptized. Back then, unbaptized babies still went to Limbo, very much like a giant unmarked grave full of dead babies who hadn’t taken the plunge for Jesus—and the messenger, a family friend, fell to pieces on the walk down Newkirk Avenue to St. Jerome Church. When the priest inside paused his Latin prayer to ask for the baby’s name, all the friend could remember was Agnes Elizabeth. She went by Betty. At some point, the last letter was switched from a Y to an O, so by the time I came along, we knew her only as Betto, lover of hot tea and the sitcom, Benson.

From an early age, the nuns forced her to use her weaker right hand in school—to be left-handed was to share the Latinate root for evil, sinistra. They trained her to be ambidextrous. For the rest of her life, her left hand had no idea what her right hand was doing.


Less than a year before he died, Joplin sat down behind a piano in a small factory in the Bronx, his brain already riddled with the syphilis that would kill him. He played six songs, perhaps the ones he remembered, perhaps the ones he wanted to be remembered by. The factory was a small brick rectangle called the Connorized Music Company on 144th Street and Austin Place. There they made the Banjorchestra and all manner of automated music machines for carnivals and houses of repute that sought live music, recording onto piano rolls the performances of the era’s great composers, the Top 40 darlings of the time, Gershwin, DeBussy, Greig, Jelly Roll Morton. There were Rube Goldberg-like music machines with thousands of pneumatic parts, some covered in a tableau-vivant of carnivals complete with a hinged-joint minstrel marionette who’d do a White-eyed dance for a nickel. The Banjorchestra was a short-lived craze. Its inventors labored mostly in vain, combining a multitude of instruments in one cabinet—piano, drums, trumpet—and coming up with new portmanteau for their hybrid machines, Banjorchestra, biding time in the hazy penumbra of the jukebox, when Edison’s records would finally burn out their business plans for good and leave them in the scorched husk of kitsch.

Though Edison’s wax cylinder and phonograph were already patented, Joplin was never recorded playing his own music live. From all accounts, Joplin was not a skilled pianist. Unlike a lot of ragtime composers, Joplin heard the music in his head and transcribed it on paper, not on the piano. Often he had to practice to play what he had written, at times setting up a paradoxical situation, where no doubt he out-wrote his own ability as a performer. Joplin would sit down and play the song and the piano converted to transcribe the notes, the hammer’s rise and fall corresponding to a carbon pencil marking the paper spooling somewhere below it. Later someone would go through and puncture each note by hand. The system left room for error. The carbon marker might not strike true or the workman’s hand might be just off center when later he punched the hole. Either way, once perforated, the roll began like an old-time window shade with a hook on the end. As the hook pulled, the air from the foot powered bellows caused air to fill the pouch inside. A hole caused a lever to push the piano key down. The roll became hashed or marked to represent the notes so that a reproducing piano could play Joplin’s composition as he had. In this way, the notes became air. Holes in paper transform into music.


Nana was a natural on the piano. Her favorite song was “Memories” from the musical Cats, and I recall her singing as she played, her soprano voice ebullient with a strong vibrato. When she wasn’t playing or singing, she was chewing Clorets. She always kept a packet in her purse that she’d share on the way to Pathmark. We were always driving to Pathmark because I very frequently had pink eye from swimming in Lake Shawnee, and the store had a pharmacy. As we drove, we shoved as many green squares into our mouths as we could fit. The barely-minted gum was always stale by the time we pulled up to the blue and red box store, where inside we’d wait for the eye drops and beg for more Clorets. Behind the pharmacy counter, shelf upon shelf of antibiotics sat in orange plastic canisters, waiting to be prescribed to anyone with money and a decent doctor.

Often times when she got home, she could not find her purse even though it was big enough to hide a child in. Either it was missing or something inside it was missing. The purse seemed to grow larger. Perhaps it grew so large we had all been enveloped in some sort of cosmological paradox, the inside so capacious that we’d live all our lives and never even glimpse a seam or a clasp.


His last year alive, between April and June, Joplin played six pieces for Connorized—and yet by then, their mechanized instruments were crude compared to those of their competitors, machines that perforated upon each strike of the note. He recorded on one such machine, his seventh roll. That record, “The Maple Leaf Rag,” perhaps one of his most iconic compositions, has a more accurate styling of his tempo, though the Connorized machines were not calibrated finely enough to capture it. Instead they relied on mathematical, metronomic timing, and sometimes a well-used bass line or two by their in-house piano player. By then, Joplin was riddled with disease, trying to scrape together cash to pay for the mercury cure. The Connorized performance of ‘The Maple Leaf Rag,’ earned him the needed funds, and yet he couldn’t know that performance ultimately meant he would not be forgotten.


Once, in the throes of a demented episode, Nana Betto called my Uncle Peter at work to ask him where her Texaco gas card was. The card was normally in the purse, but both had been misplaced. I was about six years old, but even I knew Uncle Peter wouldn’t know where it was. He worked in the city as an accountant for Brooklyn Catholic Charities and we were seventy miles away in Lake Shawnee, New Jersey, a little down the road from Lake Hopatcong. That day, we were all gathered around the phone in the kitchen—my sister, my mother, my aunt and me. Betto spoke to a secretary first, trying to track Peter down. At first I thought I’d underestimated my uncle. Maybe he had prophetic gifts I didn’t know about. Though until that point, I knew him best for teaching me how to lie down on the ground and look up Nana’s house dress when she was in the kitchen.

“Ma, I don’t know where it is,” Peter said.

“My Texaco card?” she cried. “I had it.”

“Why would I know?” Peter said.

Minutes later, my grandfather came home from the Pathmark and found the card in an older purse hanging behind the front door. He celebrated with scotch and a cigar. Every day was a celebration.


Joplin’s early history is sketchy. He was born and then became vaporous. Witnesses recount running into him in boarding houses in Arkansas, in Missouri. The ghost of a piano composition played here, a phantom piano lesson there. What friends he did have remembered him as quiet. He was famous for never smiling.


Racism kept the United States from recognizing that the Tuskegee experiment had gone terribly wrong. The government finally issued a formal apology in a ceremony in 1997. President Bill Clinton addressed the eight men who had survived the experiment, calling them “a living link to a time not so very long ago that many Americans would prefer not to remember, but we dare not forget.”

What kept the family from recognizing the dementia in my Nana was that she was a talker, a real conversationalist.  She would tell you the same story five times in a night but always starting on a different note, sometimes stringing along for a minute or two before arriving at the same familiar chorus. As a fervent Catholic, she was accustomed to such repetitions. She never missed a Mass. Each day she tuned in to Mother Angelica on EWTN and her railings  about some sinful pimple of popular culture blighting the face of Jesus—the summer of the missing Texaco card, it was Scorsese’s The Last Temptation of Christ. Crazy Jesus and the syphilitic whore Mary Magdalene had gotten hitched and she had a bunch of kids and he left her at home while he did his ministerial business. There were wine-fueled boondoggles and hearing voices on the wireless. Eventually she ended up in the bedroom hooked on pills and my grandfather sat at a table turning water into Dewars.

Sometime later, my grandfather went down with a bum hip and had surgery. A little after that, my aunt found Betto confused in the kitchen, boiling water in pots for the end of the world. She’d burned through the plastic handle on two. A black pool of plastic had melted and fused on the stovetop like an apocalyptic pancake. “You got to quit watching Mother Angelica, Ma!” my aunt told her.


In the back room, she’d play the piano after dinner. She taught my mother and aunt how to play, and when my sister played Für Elise, Nana Betto beamed. Once, at the party after my father was ordained a permanent deacon, she sat in our living room and played piano for hours. Family from both sides gathered around and accompanied her singing and playing. She knew all of the great American songbook. Cole Porter, Irving Berlin. If it played on Broadway from the war on, she had it down. Alas, I asked, but there was no Joplin that night. She had no music, no lyrics in front of her. She never played the same song twice. The next day, at my father’s first Mass, his brother approached her.

“You played so beautifully, Betty.”

“I did?” she said.

“Yes,” he said. “Last night.”

“Oh, I did?”


Scott Joplin’s favorite piece of music was an opera he never lived to see performed in full. It’s called Treemonisha. Though he published the score in 1911, he spent the last years of his life trying to secure the funding for a full performance. In 1915, part of the piece premiered, a ballet from Act Two, “Frolic of the Bears,” but was largely ignored. Over the next year and a half, the syphilis invaded his nervous system and damaged his heart. Joplin subsequently had a breakdown, and, in that weakened state, finally succumbed to the disease. He was buried with two strangers in an unmarked grave in a Bronx potter’s field.

Eventually, Nana’s memory went only as far as 1973, the same year the US Congress held the first hearings on the Tuskegee Study. I was born in 1977, and on one occasion, I was having dinner with Nana and she introduced herself as Betty, describing my mother as though she were a stranger to me. Every day she remembered the terrible and tragic moments of her life as a young woman, cried, then forgot them all over again. In 2014, she died in Far Rockaway, Queens and was buried in Brooklyn next to my grandfather.


Of all the songs people associate with a player piano, Joplin’s “The Entertainer” is the one that most often comes to mind. After all, this is the song that in 1973 led activists and archivists to find Joplin’s unmarked grave. This was after the release of the Academy Award-winning film The Sting, which featured “The Entertainer” as its theme. The song stuck in the popular consciousness long enough for me to find it rubbing shoulders with “Piano Man” and “Goodbye Yellow Brick Road” in an anthology called Great Hits of the 70s; a song that kept me coming back to my piano teacher’s house just to hear a few bars, a song that resurrected Joplin and ragtime for good, that would forever be the earworm of kiddie carnivals and ice cream trucks and shitty sleight of hand magicians—a song that, of the seven Joplin recorded on the music rolls for all time, does not appear.

The absence of this song on a piano roll is perhaps Joplin’s final comment on his music and life. It’s the silent air that shakes my hinges now and then. After four years of piano lessons, I never did learn to play the song. I can’t even read music. To my eye, the notes are no different than a series of black dots on the page, a cluster of tiny graves on a potter’s field.

All I have is an ear for his music. Its rhythm and syncopated pulse clean out my head, and there are no words but he’s singing, my Nana too, so I lean toward them, strain to hear him, still dancing, whisper back at me, his lyric, my Nana harmonizing: “What’s so goddamned entertaining about it anyway?”



Patrick Crerand lives with his wife and three kids in Dade City, Florida. He writes fiction and essays which have appeared in McSweeney’s Quarterly ConcernConjunctionsNew Orleans ReviewNinth LetterIndiana ReviewCimarron Review among others. Currently, he is an Associate Professor of English Literature and Creative Writing at Saint Leo University in Florida, where he also teaches in the Low-Residency MA program.